Abstract

SESSION TITLE: Imaging Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Ultrasound is an essential diagnostic tool in the intensive care unit (ICU). Although ultrasound is frequently the only diagnostic imaging modality available in resource-limited countries (RLCs), these countries often lack clinicians with expertise obtaining and interpreting ultrasound images. We previously demonstrated that remote intensivists can guide minimally trained non-physicians to obtain high-quality ultrasound images using e-ICU technology and that ultrasound images transmitted locally by FaceTime are of similar quality to those transmitted by e-ICU technology. Because e-ICU software can be prohibitively expensive for RLCs, commercially available video-chat software may present an affordable alternative. Unfortunately, the quality of internet connectivity throughout the developing world can be unreliable, and technological advances proven domestically may not be feasible in RLCs. We conducted a feasibility pilot to evaluate the quality of ultrasound images obtained by non-physicians in a developing country using a remote tele-mentored ultrasound system constructed using commercially available video-chat software.

METHODS: An ultrasound-trained physician provided a 10-minute training session on the use of the SonoSite ultrasound machine to Haitian non-physicians. A remote tele-intensivist located at the University of Maryland used an Apple MacBook operating FaceTime to provide real-time direction to the non-physician “ultrasonographer” located near Port-au-Prince, Haiti. Images of the ultrasonographer and the ultrasound machine were transmitted to the remote tele-intensivist using a wireless internet connection and an iPhone 5 operating FaceTime. The non-physician obtained images of the right internal jugular vein, bilateral lung apices and bases, heart (subxiphoid view), and bladder. The tele-intensivist completed an image checklist and used a five-point Likert scale to evaluate to the image quality.

RESULTS: Nine Haitian non-physicians obtained sixty-three images. The intensivist agreed (defined as “agree” or “strongly agree” on a five-point-Likert scale) that 90% (57/63) of the FaceTime images were high quality. The intensivist felt comfortable making clinical decisions using FaceTime images 89% (56/63) of the time.

CONCLUSIONS: High-quality, clinically relevant ultrasound images can be captured using commercially available video-chat software in RLC's.

CLINICAL IMPLICATIONS: Commercially available video-chat software can affordably optimize the clinical role of ultrasonography in RLC's.

Return to: High Quality Ultrasound Images Can Be Acquired by Nonphysicians in Developing Countries Instructed by Tele-Intensivists Using Commercially Available Video-Chat Technology

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